Surgery, Gastroenterology and Oncology
Vol. 24, Nr. 1, Feb 2019
Bronchobiliary Fistula due to Hydatid Liver Cyst and Role of Bile Leakage Test during Surgical Treatment
Egemen Cicek, Cemalettin Koc, Tolga Sahin, Cihan Gokler, Aydin Aktas, Cuneyt Kayaalp, Akimasa Nakao
Images in Clinical Medicine, Feb 2019
Article DOI: 10.21614/sgo-24-1-56
Background: Bronchobiliary fistula (BBF) is a rare complication of the hydatid liver disease. The diagnosis depends on clinical suspicion and radiologic evaluation. Surgical treatment is the mainstay way for the complicated hydatid liver cysts.
However, postoperative biliary fistula can make the situation more complicated. Bile leak test may be helpful for the prevention of this complication. In this study, the surgical management of a patient who developed BBF due to liver hydatid cyst was discussed with the literature.

Case Presentation: A patient (45-year-old female) withbilioptysis was diagnosed as BBF due to hydatid liver disease (segment VII, 7 cm) and operated via transabdominal approach. Intraoperative cholangiography confirmed the BBF and hydatid liver cyst was treated by partial pericystectomy. Bile leakwas determined by leak testsusing methylene blue, biliary orifices were sutured and cavity was managed by omentoplasty. Furthermore, the fistula tract to the bronchi was closed by sutures.
Postoperative course was uneventful and she was discharged on postoperative 7th day. After a 14 months follow-up, there was no recurrence and she was asymptomatic.

Conclusions: Bile leak test can be used in complicated hydatid liver cysts such as BBF.

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Surgery, Gastroenterology and Oncology is indexed in Scopus, CrossRef (DOI: 10.21614/sgo)

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